scholarly journals Transabdominal approach for renal cell carcinoma with supradiaphragmatic tumor thrombus: description of a modified technique and indications for treatment

2020 ◽  
Vol 48 (11) ◽  
pp. 030006052096228
Author(s):  
Guoliang Wang ◽  
Hai Bi ◽  
Jianfei Ye ◽  
Hongxian Zhang ◽  
Xiaofei Hou ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Tumor Thrombus ◽  
Foley Catheter ◽  
Vena Cava ◽  
Modified Technique ◽  
Abdominal Incision ◽  
Transabdominal Approach ◽  
Estimated Blood Loss

Objective We investigated the safety and effectiveness of a modified transabdominal approach for renal cell carcinoma (RCC) with a supradiaphragmatic inferior vena cava (IVC) tumor thrombus (TT). Methods Eight patients underwent radical nephrectomy with removal of a supradiaphragmatic IVC-TT through an abdominal incision using a transdiaphragmatic approach in Peking University Third Hospital from April 2015 to January 2018. We modified this technique using a Foley catheter balloon to avoid piggyback liver mobilization. Results All patients underwent successful operations. The median operative time was 7 hours 23 minutes. The median estimated blood loss was 2963 mL. All patients received a blood transfusion with a median blood infusion volume of 2162 mL. Two patients with Budd–Chiari syndrome developed postoperative ascites and hydrothorax due to non-watertight repair of the diaphragm. During a follow-up of 11 to 44 months, only one patient died of liver metastasis and four patients developed distant metastasis without recurrence in the IVC. Conclusions The modified transabdominal approach described herein has an encouraging safety profile and provides a surgical option for treatment of RCC with a supradiaphragmatic IVC-TT. More evidence concerning the beneficial role of this procedure will be elucidated in further studies.

scholarly journals Renal Cell Carcinoma with or without Tumor Thrombus Invading the Liver, Pancreas and Duodenum

Cancers ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 1695
Author(s):  
Javier González ◽  
Jeffrey J. Gaynor ◽  
Gaetano Ciancio
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Tumor Thrombus ◽  
Locally Advanced ◽  
Vena Cava ◽  
Complication Rates ◽  
Durable Response ◽  
Estimated Blood Loss ◽  
Level I

Background: The purpose of this study is to report the outcomes of a series of patients with locally advanced renal cell carcinoma (RCC) who underwent radical nephrectomy, tumor thrombectomy, and visceral resection. Patients and methods: 18 consecutive patients who underwent surgical treatment in the period 2003-2019 were included. Neoplastic extension was found extending into the pancreas, duodenum, and liver in 9(50%), 2(11.1%), and 7(38.8%) patients, respectively. Seven patients (38.8%) presented also inferior vena cava tumor thrombus level I (n = 3), II (n = 2), or III (n = 2). The resection was tailored according to the degree of invasiveness. Demographics, clinical presentation, disease characteristics, surgical details, 30-day postoperative complications, and overall survival (OS) were analyzed. Results: Median age was 56 years (range: 40–76). Median tumor size was 14.5 cm (range, 8.8–22), and 10 cm (range: 4–15) for those cases with pancreatico-duodenal and liver involvement, respectively. Median estimated blood loss (EBL) was 475 mL (range: 100–4000) and resulted higher for those cases requiring thrombectomy (300 mL vs. 750 mL). Nine patients (50%) required transfusions with a median requirement of 4 units (range: 2–8). No perioperative deaths were registered in the first 30 days. Overall complication rate was 44.4%. Major complications were detected in 6/18 patients (33.3%). Overall median follow-up was 24 months (range: 0–108). Five-year OS (actuarial) rate was 89.9% and 75%, for 9/11 patients with pancreatico-duodenal involvement and 6/7 patients with liver invasion, respectively. Conclusion: Our series establishes the technical feasibility of this procedure with acceptable complication rates, no deaths, and potential for durable response.

C229: Treatment of renal cell carcinoma with tumor thrombus in vena cava inferior-own experiences

2014 ◽  
Vol 13 (6) ◽  
pp. e1392
Author(s):  
W. Różański ◽  
M. Markowski ◽  
M. Wrona ◽  
P. Lipiński ◽  
M. Lipiński ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Tumor Thrombus ◽  
Vena Cava ◽  
Vena Cava Inferior

scholarly journals Sonographic Evaluation of Inferior Vena Cava Tumor Thrombus in Renal Cell Carcinoma: A Case Study of a Rare Condition

2018 ◽  
Vol 34 (5) ◽  
pp. 375-382
Author(s):  
Viyana Hamblen
Keyword(s):  
Renal Cell Carcinoma ◽  
Inferior Vena Cava ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Tumor Thrombus ◽  
Inferior Vena ◽  
Wilms Tumor ◽  
Circulatory Arrest ◽  
Vena Cava ◽  
Ivc Tumor

Inferior vena cava (IVC) tumor thrombus in renal cell carcinoma is a rare entity that suggests heightened biologic behavior and a surgical challenge during the course of treatment. Tumor thrombus can extend from the renal vein to the right atrium. This cephalad extension is classified by four different levels. These levels determine which surgical approach is used, whether a thoracoabdominal incision is needed, and whether a patient needs to be placed in circulatory arrest. Complete surgical resection of the tumor is potentially the only curative treatment, although it supposes a challenge because of operative difficulty and the potential for massive bleeding or tumor pulmonary thromboembolism. IVC tumor thrombus presents with a few differentials that need to be assessed, including bland thrombus, primary IVC leiomyosarcoma, hepatocellular carcinoma, adrenal cortical carcinoma, primary lung carcinoma, and Wilms tumor. The importance of diagnosing IVC tumor thrombus secondary to renal cell carcinoma is demonstrated as well as a sonographic protocol for assessing IVC tumor thrombus.

scholarly journals Role of presurgical targeted molecular therapy in renal cell carcinoma with an inferior vena cava tumor thrombus

2018 ◽  
Vol Volume 11 ◽  
pp. 1997-2005 ◽  
Author(s):  
Cheng Peng ◽  
Liangyou Gu ◽  
Lei Wang ◽  
Qingbo Huang ◽  
Baojun Wang ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Inferior Vena Cava ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Tumor Thrombus ◽  
Inferior Vena ◽  
Vena Cava ◽  
Molecular Therapy ◽  
Targeted Molecular Therapy

scholarly journals Single Stage Resection of Renal Cell Carcinoma with Right Atrial Extension– A Case Report

2018 ◽  
Vol 36 (2) ◽  
pp. 77-79
Author(s):  
Syed Al Nahian ◽  
Sonjoy Biswas ◽  
Rezaul Hassan ◽  
M Zahid Hasan
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Right Atrium ◽  
Primary Tumor ◽  
Renal Cell ◽  
Renal Vein ◽  
Tumor Thrombus ◽  
Vena Cava ◽  
Single Stage ◽  
Right Atrial

Renal cell carcinoma (RCC) is the commonest primary tumor of the kidney which may invade through the renal vein into the inferior vena cava (IVC), and then it can extend intraluminally with subsequent tumor-thrombus formation. Here we report a case involving excision of a primary RCC with tumor-thrombus involving IVC up to right atrium with the use of extracorporeal circulation. Single stage surgical procedure was performed in collaboration with a urological team aiming complete resection of primary tumor, para-aortic lymphadenectomy and removal of IVC thrombus extending to right atrium with the help of cardiopulmonary bypass. After arresting heart, RA was opened and the mass was removed through RA from IVC and hepatic vein level. Abdominal IVC was opened and the entire residual mass was removed from below also small amount of thrombus removed from left renal vein. Postoperative venous doppler showed no residual thrombus in venous system. Histopathology report confirmed papillary renal cell carcinoma. The patient was discharged from hospital in the 12th post-operative day without any complication.J Bangladesh Coll Phys Surg 2018; 36(2): 77-79

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